Radioactive Materials Laboratory Survey Report (RPS-5)

Radioactive materials workers use this form to document surveys performed in the lab.


  • A documented survey (using this form) is required at least once every month radioactive materials are used. 
  • The Survey Report is due at Environment, Health & Safety on the first day of the month to report the status of the lab during the previous month. 
  • If no radioactive material is used during the month, no survey is required. Indicate that the lab was inactive and submit the form.

Need Help Completing the Form?

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Environment, Health & Safety Radiation Safety

Service Building, 220 Winspear Ave.

Phone: 716-829-3281


Form Facts

Form Type: Formstack document

Requirements: none

Updated: 06/26/2017

Owner: Environment, Health & Safety